Which drugs are noted for interacting with B-12 (Cobalamin)?

The interaction of certain medications with vitamin B-12 (cobalamin) is crucial for understanding both nutritional status and potential deficiencies in older adults. Cimetidine and neomycin are recognized for their interactions with B-12.

Cimetidine is a histamine H2-receptor antagonist that reduces stomach acid secretion, which can lead to decreased absorption of vitamin B-12 due to altered gastric pH and intrinsic factor availability. Intrinsic factor is essential for the absorption of B-12 in the intestine. When the absorption process is hindered, it can lead to lower levels of available B-12 in the body.

Neomycin, an aminoglycoside antibiotic, can also negatively affect B-12 absorption due to its action in the intestines, disrupting the normal gut flora that may be needed for B-12 digestion and absorption.

The other options do not have the same level of documented interaction with vitamin B-12. Aluminum hydroxide primarily affects the absorption of other nutrients but has a less direct impact on B-12. Warfarin, while an important anticoagulant, does not have a significant interaction with vitamin B-12. Similarly, estrogen and haloperidol are not known for disrupting B-12 absorption.

Understanding